27 resultados para rapid diagnostic test

em Deakin Research Online - Australia


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Biomarkers have been described as characteristics, most often molecular, that provide information about biological states, whether normal, pathological, or therapeutically modified. They hold great potential to assist diagnosis and prognosis, monitor disease, and assess therapeutic effectiveness. While a few biomarkers are routinely utilised clinically, these only reflect a very small percentage of all biomarkers discovered. Numerous factors contribute to the slow uptake of these new biomarkers, with challenges faced throughout the biomarker development pipeline. Microfluidics offers two important opportunities to the field of biomarkers: firstly, it can address some of these developmental obstacles, and secondly, it can provide the precise and complex platform required to bridge the gap between biomarker research and the biomarker-based analytical device market. Indeed, adoption of microfluidics has provided a new avenue for advancement, promoting clinical utilisation of both biomarkers and their analytical platforms. This review will discuss biomarkers and outline microfluidic platforms developed for biomarker analysis.

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An amino acid consensus sequence for the seven serotypes of foot-and-mouth disease virus (FMDV) nonstructural protein 3B, including all three contiguous repeats, and its use in the development of a pan-serotype diagnostic test for all seven FMDV serotypes are described. The amino acid consensus sequence of the 3B protein was determined from a multiple-sequence alignment of 125 sequences of 3B. The consensus 3B (c3B) protein was expressed as a soluble recombinant fusion protein with maltose-binding protein (MBP) using a bacterial expression system and was affinity purified using amylose resin. The MBP-c3B protein was used as the antigen in the development of a competition enzyme-linked immunosorbent assay (cELISA) for detection of anti-3B antibodies in bovine sera. The comparative diagnostic sensitivity and specificity at 47% inhibition were estimated to be 87.22% and 93.15%, respectively. Reactivity of c3B with bovine sera representing the seven FMDV serotypes demonstrated the pan-serotype diagnostic capability of this bioreagent. The consensus antigen and competition ELISA are described here as candidates for a pan-serotype diagnostic test for FMDV infection.

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Standards for teaching emphasise the need for teachers to have deep content knowledge. To assess the mathematical knowledge of students enrolling in its B.Ed. program, the University of New England has introduced a mathematics diagnostic test. This work is the first stage of an ongoing research project into the numeracy needs of students entering the B.Ed. program. The test is a pen-andpaper test that replaces previous on-line, multiple-choice tests. This paper reports on the test results, discusses some common errors made by students and outlines the future direction of the research.

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Menkes disease is a copper deficiency caused by mutations in the Menkes gene, which encodes a copper-transporting protein. This study identified the causative mutations in several Menkes patients, which provided a diagnostic test for relatives and identified critical regions of the Menkes protein. Further regions were identified through functional analysis of mutations introduced by in vitro mutagenesis.

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Glycated haemoglobin (HbA<sub>1c</sub>) reflects the average blood glucose level in the three months preceding the test. Changes in consecutive HbA<sub>1c</sub> tests indicate deteriorating, or improved, glycaemic control. HbA<sub>1c</sub> is considered to be the "gold standard" measure of blood glucose control and is often used as the basis for prescribing choices and other care decisions. A number of factors can affect the accuracy of the HbA<sub>1c</sub> result, for example, the life span of red blood cells, assay methods and clinicians' awareness of possible interfering factors. The aim of this article is to outline how HbA<sub>1c</sub> is used as a diagnostic test, how it is used to monitor glycaemic control and how it can guide management decisions. It is also important to emphasise the importance of considering HbA<sub>1c</sub> in the context of the individual rather than as an isolated number.

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Clubroot, caused by Plasmodiophora brassicae, is one of the most important diseases of brassicas. Management of clubroot is difficult, and the best means of avoiding the disease include planting in areas where P. brassicae is not present and using plants and growing media free from pathogen inoculum. As P. brassicae is not culturable, its detection has traditionally relied on plant bioassays, which are time-consuming and require large amounts of glasshouse space. More recently, fluorescence microscopy, serology, and DNA-based methods have all been used to test soil, water, or plant samples for clubroot. The use of fluorescence microscopy to detect and count pathogen spores in the soil requires significant operator skill and is unlikely to serve as the basis for a routine diagnostic test. By contrast, serologic assays are inexpensive and amenable to high-throughput screening but need to be based on monoclonal antibodies because polyclonal antisera cannot be reproduced and are therefore of limited quantity. Several polymerase chain reaction (PCR)-based assays have also been developed; these are highly specific for P. brassicae and have been well-correlated with disease severity. As such, PCR-based diagnostic tests have been adopted to varying extents in Canada and Australia, but wide implementation has been restricted by sample processing costs. Efforts are underway to develop inexpensive serologic on-farm diagnostic kits and to improve quantification of pathogen inoculum levels through real-time PCR. Proper detection and quantification of P. brassicae will likely play an increasingly important role in the development of effective clubroot management strategies.

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A rapid method for screening drug seizure samples for 3,6-diacetylmorphine (heroin), which consists of a simple hydrolysis procedure and flow-injection analysis with two chemiluminescence reagents, is described. Before hydrolysis, 3,6-diacetylmorphine evokes an intense response with a tris(2,2'-bipyridyl)ruthenium(III) reagent (prepared by dissolving the perchlorate salt in acetonitrile), and a relatively weak chemiluminescence response with a second reagent: potassium permanganate in an aqueous acidic polyphosphate solution. However, the permanganate reagent is extremely sensitive toward the hydrolysis products of 3,6-diacetylmorphine (i.e., 6-monoacetylmorphine and morphine). Some compounds commonly found in drug laboratories may cause false positives with tris(2,2'-bipyridyl)ruthenium(III), but do not produce the markedly increased response with the permanganate reagent after the hydrolysis procedure. The combination of these two tests therefore provides an effective presumptive test for the presence of 3,6-diacetylmorphine, which we have verified with 14 samples obtained from a forensic science laboratory.

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A method is described for making rapid in situ field measurements of riverbed topography over spatial scales of ≅1–10 m. This method uses rolling balls to make quick, accurate measurements of river-bed roughness at several spatial scales. Random sampling and replication generate multiple estimates of the fractal dimension (d) that can be used to test for significant differences in the complexity of riverbed architecture between habitat types and spatial scales.

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A simple and rapid method for the analysis of carbohydrates in heroin samples by capillary electrophoresis utilizing a borate complexation method is described. Separations were performed using an uncoated fused silica capillary, 50 cm × 50 mm I.D. × 360 mm O.D. with an effective separation length of 9 cm. The system was run at 60°C with an applied voltage of -8 kilovolts. Injection of each sample was for 1 sec at -50 mbar. UV detection was employed with the wavelength set at 195 nm. The background electrolyte consisted of 65 mM borate, pH 12.0. Samples and standards were prepared in the run buffer containing 2 mg/mL of mannose as an internal standard. Under these conditions a test mixture containing glucose, sucrose, lactose, mannitol and mannose as an internal standard was resolved within 5 min. The method was used to determine the concentration of carbohydrates in heroin seizure samples and synthetic heroin samples. The results were in good agreement with the reported values.

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In this study, a novel method for manufacturing composite tubes utilizing the QuickstepTM process has been developed. Tubes manufactured from `quick-cure' Toray G83C prepreg have demonstrated highly repeatable axial crush behavior with an average specific energy absorption (SEA) of 86 kJ/kg. The cure cycle is optimized by comparing the results from compression, dynamic mechanical thermal analysis (DMTA), differential scanning calorimetry (DSC), and porosity testing. The tube lay-up is optimized using compression and porosity test results. The effect of changes in fiber-orientation on SEA is also investigated. Process development has resulted in a robust manufacturing method capable of producing fully cured, high performance composite tubes with a cure cycle of 7 min. This corresponds to a 95% reduction in time compared to an equivalent autoclave cycle.

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Teachers require a range of knowledge bases, including both content knowledge and pedagogical knowledge (Shulman, 1986). In recent times there have been calls from a variety of sources for teacher preparation courses to improve the mathematical knowledge of teachers, particularly primary teachers. These calls have been underlined by the recent formation of bodies such as the Institutes of Teachers in Victoria and NSW, as well as the development of teaching standards by professional bodies including the Australian Association of Mathematics Teachers. Rather than simply adopt a "back-to-basics" approach, work is required that uses the results of educational research to design courses that help pre-service students to understand how and why errors are made (by themselves and by children in their own classrooms). Diagnostic testing of preservice students is the first step in the process. However, it is not enough to simply test students and to remediate their misconceptions. Instead, the aim is to use the results of the testing to improve students' pedagogical knowledge as well as their subject content knowledge. This paper outlines one approach to the use of diagnostic testing with pre-service students and how the results can be used to assist in the development of pedagogical knowledge.

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PURPOSE: To prospectively evaluate accuracy of sonography for diagnosis of carpal tunnel syndrome (CTS) in patients clinically suspected of having the disease in one or both hands.
MATERIALS AND METHODS: A prospective cohort of 133 patients suspected of having CTS were referred to a teaching hospital between October 2001 and June 2002 for electrodiagnostic study. One hundred twenty patients (98 women, 22 men; mean age, 49 years; range, 19–83 years) underwent sonography within 1 week after electrodiagnostic study. Radiologist was blinded to electrodiagnostic study results. Seventy-five patients had bilateral symptoms; 23 patients, right-hand symptoms; and 22 patients, left-hand symptoms (total, 195 symptomatic hands). Cross-sectional area of median nerve was measured at three levels: immediately proximal to carpal tunnel inlet, at carpal tunnel inlet, and at carpal tunnel outlet. Flexor retinaculum was used as a landmark to margins of carpal tunnel. Optimal threshold levels (determined with classification and regression tree analysis) for areas proximal to and at tunnel inlet and at tunnel outlet were used to discriminate between patients with and patients without disease. Sensitivity, specificity, and false-positive and false-negative rates were derived on the basis of final diagnosis, which was determined with clinical history and electrodiagnostic study results as reference standard.
RESULTS: For right hands, sonography had sensitivity of 94% (66 of 70); specificity, 65% (17 of 26); false-positive rate, 12% (nine of 75); and false-negative rate, 19% (four of 21) (cutoff, 0.09 cm2 proximal to tunnel inlet and 0.12 cm2 at tunnel outlet). For left hands, sensitivity was 83% (53 of 64); specificity, 73% (24 of 33); false-positive rate, 15% (nine of 62); and false-negative rate, 31% (11 of 35) (cutoff, 0.10 cm2 proximal to tunnel inlet).
CONCLUSION: Sonography is comparable to electrodiagnostic study in diagnosis of CTS and should be considered as initial test of choice for patients suspected of having CTS.

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Monoclonal antibodies were developed against pathogenic vibrios for use in rapid identification in disease situations of humans, fish and shellfish. Of the 12 fusions performed using V. alginolyticus, V. anguillarum, V. carchariae, V. cholerae, V. damsela, V. furnissii, V. harveyi, V. ordalii, V. parahaemolyticus and V. vulnificus, a total of 102 hybridomas were obtained. Based on cross-reactivity of a wide range of Vibrio strains and other gram-negative bacteria, three broad types of monoclonal antibodies were found. The three categories were: (1) ones that were species-specific or specific to a particular surface antigen, (2) a large number that reacted with several Vibrio species, and (3) three that reacted with most Vibrio strains but no other gram-negative bacteria. Each species-specific monoclonal antibody only recognized its corresponding Vibrio species and was used for identifying unknown species, confirming diagnosis of clinical isolates. In addition, several monoclonal antibodies only cross-reacted with similar Vibrio species, e.g. V. parahaemolyticus and V. alginolyticus which share a common H-antigen. Monoclonal antibodies reacting with several Vibrio species were not of particular use in diagnostic situations. Three monoclonal antibodies of the last group did not react with other genera of the family Vibrionaceae, namely Aeromonas, Photobacterium and Plesiomonas nor a wide range of gram-negative enteric bacteria. These data indicated the existence of an antigenic surface determinant common to Vibrio species. One monoclonal reacted with the heat-stable antigenic determinants on the cell surface as v as lipopolysaccharide extracted from all the vibrios studied, thus making it useful for large- scale screening of acute infections of vibrios. In a blind test, seven Vibrio species, isolated from 6 marine and a freshwater source were identified by two laboratories using phenetic tests. Results of immunotyping using monoclonals, three of seven were diagnosed as the same species, another three were designated as Vibrio species but could not be classified further due to the library not having the corresponding monoclonal, and one was diagnostically questionable. Two further tests were carried out. An unknown Vibrio formalin-fixed isolated from diseased marine animal was identified as V. parahaemolyticus by ELISA and FITC. Clinical human isolates of V. alginolyticus, V. parahaemolyticus and V. vulnificus were confirmed by monoclonals. Australian isolates of V. anguillarum appeared to be mostly of serotype O1. monoclonals raised to V. anguillarum AFHRL 1 reacted with only serotype O1 from Denmark but also most Australian isolates. All vibrios pathogenic to fish and shellfish, i.e. V. anguillarum, V. ordalii, V. alginolyticus, V. carchariae, V. cholerae, V. damsela, V. harveyi, V. parahaemolyticus and V. vulnificus, were used for attachment studies to fish cells using phase contrast and FITC-immunofluorescence microscopy. Of these vibrios, V. anguillarum, V. ordalii and V. perahaemolyticus, were found to adhere to different cells and tissues of rainbow trout while others did not appear to attach. However, attachment was inhibited by monoclonal antibodies specific to only these three vibrios. Lipopolysaccharide is well known as being a contributing factor in pathogenicity of gram-negative bacteria. PAGE electrophoresis of extracted LPS from 9 strains covering 6 Vibrio species showed the presence of a common 15,000 D fragment. This fragment was verified by immunoblotting with a genus-specific monoclonal antibody (i.e. F11P411F) recognizing nearly all vibrios. The common LPS fragment was separated and used to raise polyclonal antisera in mouse which reacted strongly with LPS itself, live as well as sodium azide-killed vibrios, but not with other gram-negative bacteria. This raised the possibility of developing vaccine from Vibrio LPS. Monoclonal antibodies developed in the present study enabled rapid identification of a number of pathogenic Vibrio species. There is still further work to produce monoclonal antibodies against additional vibrios that are probably pathogenic. These included V. fluvialis, V. hollisae, V. metschnikovii, V. minicus, V. salmonella and V. tubiashii. Together the application will be of significance in clinical diagnostic work, in the monitoring of vibriosis in fish farms and in quarantine.

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This thesis reviews progress toward an understanding of the processes involved in the solution of spatial problems. Previous work employing factor analysis and information processing analysis is reviewed and the emphasis on variations in speed and accuracy as the major contributers to individual differences is noted. It is argued that the strategy used by individuals is a preferable explanatory concept for identifying the cognitive substratum necessary for problem solving. Using the protocols obtained from subjects solving The Minnesota Paper Form Board (Revised), a test commonly regarded as measuring skill in spatial visualization, a number of different strategies are isolated. Assumptions as to the task variants which undergird these strategies are made and tested experimentally. The results suggest that task variants such as the size of the stimulus and the shape of the pieces interact with subject variables to produce the operating strategy. Skill in problem solving is revealed in the ability to structure the array, to hold a structured image and to reduce the number of answers requiring intensive processing. The interaction between task and subject variables results in appropriate or inappropriate strategies which in turn affect speed and accuracy. Results suggest that strategy formation and usage are the keys to explaining individual differences and an heuristic model is presented to explain the performance of individual subjects on the problems involved in the Minnesota Paper Form Board. The model can be used to predict performance on other tests; and as an aid to teaching subjects experiencing difficulties. The model presented incorporates strategy variation and is consequently mores complex than previously suggested models. It is argued that such complexity is necessary to explain the nature of a subject's performance and is also necessary to perform diagnostic evaluation. Certain structural -features of the Minnesota Paper Form Board are questioned and suggestions for improvement included. The essential explanatory function of the strategy in use makes the prevalent group administration approach suspect in the prediction of future performance in spatial or vocational activity.